The epidemiology of proximal humeral fractures

Court-Brown, Charles M.; Garg, Ashima; McQueen, Margaret M.

doi:10.1080/000164701753542023

Cited by 743 publications

(440 citation statements)

References 9 publications

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“…Fractures of the proximal humerus are usually attributable to osteoporosis [21] and are mostly caused by low-energy trauma [5]. In Germany, there has been an increased incidence of proximal humeral fractures over the last several years with approximately 60,000 fractures in 2010 [6].…”

Section: Introductionmentioning

confidence: 99%

Deltoid-split or Deltopectoral Approaches for the Treatment of Displaced Proximal Humeral Fractures?

Buecking

Mohr

Bockmann

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Proximal humeral fractures are mainly associated with osteoporosis and are becoming more common with the aging of our society. The best surgical approach for internal fixation of displaced proximal humeral fractures is still being debated. Questions/purposes In this prospective randomized study, we aimed to investigate whether the deltoid-split approach is superior to the deltopectoral approach with regard to (1) complication rate; (2) shoulder function (Constant score); and (3) pain (visual analog scale [VAS]) for internal fixation of displaced humeral fractures with a polyaxial locking plate.Methods We randomized 120 patients with proximal humeral fractures to receive one of these two approaches (60 patients for each approach). We prospectively documented demographic and perioperative data (sex, age, fracture type, hospital stay, operation time, and fluoroscopy time) as well as complications. Followup examinations were conducted at 6 weeks, 6 months, and 12 months postoperatively, including radiological and clinical evaluations (Constant score, activities of daily living, and pain [VAS]). Baseline and perioperative data were comparable for both approaches. The sample size was chosen to provide 80% power, but it reached only 68% as a result of the loss of followups to detect a 10-point difference on the Constant score, which we considered the minimum clinically important difference. Results Complications or reoperations between the approaches were not different. Eight patients in the deltoid-split group (14%) needed surgical revisions compared with seven patients in the deltopectoral group (13%; p = 1.00). Deltoid-split and deltopectoral approaches showed similar Constant scores 12 months postoperatively (Deltoid-split 81; 95% confidence interval [CI], 74-87 versus deltopectoral 73; 95% CI, 64-81; p = 0.13), and there were no differences between the groups in terms of pain at 1 year (deltoid-split 1.8; 95% CI, 1.2-1.4 versus deltopectoral 2.5; 95% CI, 1.7-3.2; p = 0.14). No learning-curve effects were noted; fluoroscopy use during surgery and function and pain scores during followups were similar among the first 30 patients and the next 30 patients treated in each group. Conclusions The treatment of proximal humeral fractures with a polyaxial locking plate is reliable using both approaches. For a definitive recommendation for one of these approaches, further studies with appropriate sample size are necessary.

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Section: Introductionmentioning

confidence: 99%

Deltoid-split or Deltopectoral Approaches for the Treatment of Displaced Proximal Humeral Fractures?

Buecking

Mohr

Bockmann

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…In the majority of cases, these fractures are not displaced and can be treated without surgery. In a prospective consecutive series of 1,027 proximal humeral fractures, only nine percent were three-part and 3% were four-part fractures [6]. Theoretically, in threeand four-part fractures, the blood supply of the humeral head can be jeopardised, which may result in avascular necrosis of the humeral head resulting in a loss of function.…”

Section: Introductionmentioning

confidence: 99%

Primary Shoulder Arthroplasty Versus Conservative Treatment for Comminuted Proximal Humeral Fractures: A Systematic Literature Review

deHaan¹,

deHartog²,

Schep³

et al. 2010

TOORTHJ

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Abstract:The objective was to identify whether arthroplasty or conservative treatment is the best available treatment for three-and four-part proximal humeral fractures by analyzing the outcome measure of the Constant score. We conducted an electronic search. The systematic review included 33 studies encompassing 1096 patients with three-or four-part proximal humeral fractures that used the Constant score as outcome measure. The mean Constant score in the conservative group was 66.5 and in the arthroplasty group was 55.5. The difference could be attributed to selection bias, unreliable classification of the fractures and inter-observer differences in the assessment of the Constant score.

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“…The overall prevalence is about 70 per 100000 population/year, representing about 5% of all fractures [17][18][19]. Restoration of muscle power to the injured arm is not the prime objective in elderly patients.…”

Section: Discussion:-mentioning

confidence: 99%

Percutaneous K-Wire Fixation for a Comminuted Proximal Humerus Fracture – A Case Report.

Khan¹,

Kumar²,

Haidry³

et al. 2017

IJAR

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The epidemiology of proximal humeral fractures

Cited by 743 publications

References 9 publications

Deltoid-split or Deltopectoral Approaches for the Treatment of Displaced Proximal Humeral Fractures?

Deltoid-split or Deltopectoral Approaches for the Treatment of Displaced Proximal Humeral Fractures?

Primary Shoulder Arthroplasty Versus Conservative Treatment for Comminuted Proximal Humeral Fractures: A Systematic Literature Review

Percutaneous K-Wire Fixation for a Comminuted Proximal Humerus Fracture – A Case Report.

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